【摘要】 目的:探讨美蓝灌注染色在膀胱镜下膀胱癌电切术中的作用。方法:选择10例膀胱移行细胞癌病人,术前1h膀胱内注入0.1%美蓝溶液50mL,保留至术中,膀胱镜下用生理盐水冲洗多遍,然后在电切肉眼大体肿瘤的同时,对蓝染的部位黏膜取活检,并全部予以电灼。同时随机钳取非蓝染黏膜1~2处作对照。结果:10例中共取蓝染区活检16处,非蓝染区活检11处。病理报告:蓝染区,慢性炎症6例,肉芽组织增生2例,纤维结缔组织水肿1例,坏死细胞2例,钙化斑1例,移行细胞上皮乳头状瘤2例,腺性膀胱炎1例,细胞非典型增生1例。非蓝染区病理均为正常黏膜。结论:美蓝着色试验对异常膀胱黏膜细胞有指示作用。膀胱镜下对蓝染区观察更清楚,对提高膀胱癌的疗效,预防复发有积极作用。在泌尿外科向微创及腔镜发展的趋势下,应将美蓝染色作为膀胱肿瘤电切术中的一项常规应用。更多还原

【Abstract】 Objective:To study the effect of methylene blue perfusion staining on the electrotomy of urinary bladder carcinoma under cystoscope.Methods: Ten patients with urinary bladder transitional cell cancer were perfused with 50mL 0.1% methylene blue solution into urinary bladder one hour before surgery.During surgery,urinary bladder was flushed a few times with normal saline water under cystoscope to electroresect macroscopic carcinoma.Meanwhile,mucous membrane in methylene blue stained position was sampled for biopsy and totally fulgurated.Non-stained mucous membrane was also randomly protracted for control.Results: Among the ten cases,16 stained places and 11 non-stained places were sampled for biopsy altogether.For the stained places,six cases indicated chronic inflammation;two cases granulation tissue hyperplasia;one case fibrous connective tissue edema;two cases necrosis cell;one case calcified spot;two cases transitional cell epithelial papilloma;one case glandular cystitis;and one case atypical cell multiplication.Non-stained places indicated only normal mucous membrane pathologically.Conclusions: Methylene blue stained test can indicate atypical urinary bladder mucous membrane cell.The application of cystoscope can improve therapeutic effect of urinary bladder carcinoma and positively prevent its recurrence.Methylene blue staining should become a regular procedure in urinary bladder carcinoma electrotomy as urinary surgery develops for minimal invasion and cavity speculum.更多还原